Wegovy Doses Explained: The 0.25mg to 2.4mg Titration Schedule

Wegovy (semaglutide) injections start at 0.25mg once a week and increase every four weeks through 0.5mg, 1mg and 1.7mg to the 2.4mg maintenance dose, which most people reach at week 17. Since January 2026, the UK licence also allows adults with obesity to move up to 7.2mg weekly after at least four weeks on 2.4mg. The slow build-up is designed to reduce side effects such as nausea, not to delay results. This guide explains each step, what the SmPC says about missed doses, delaying increases and changing your injection day, and why dose decisions belong to your prescriber.

The standard Wegovy dose schedule

The table below shows the dose schedule set out in the UK Summary of Product Characteristics (SmPC) and Patient Information Leaflet (PIL).

Each Wegovy FlexTouch pen in the UK contains four weekly doses of one strength, so each step in the schedule usually corresponds to one pen. Our guide to using the Wegovy FlexTouch pen explains how to inject. For an overview of the medicine, see the Wegovy hub and the complete UK guide to Wegovy.

Why the dose increases gradually

Semaglutide's most common side effects, including nausea, vomiting and diarrhoea, are dose-related and most likely when the dose changes. Starting low and increasing every four weeks gives the body time to adapt. In the STEP trials, gastrointestinal side effects were most common during the 16-week escalation period and generally settled afterwards.

The low doses are not expected to produce much weight loss on their own. Some people notice reduced appetite early, while others notice little until they reach the higher doses. Both are normal.

Why four weeks?

Semaglutide has a half-life of about one week, so it takes around four to five weeks to reach steady levels at each dose. Staying on each dose for at least four weeks allows levels to stabilise and side effects to settle before the next increase.

Each dose in more detail

0.25mg (weeks 1 to 4)

The starting dose. Its purpose is tolerability rather than weight loss. Some people experience mild nausea or appetite changes; many notice little. It is a good time to establish a routine: choosing your injection day, learning to use the pen and practising smaller meals.

0.5mg (weeks 5 to 8)

Many people begin to notice appetite effects at this stage. Side effects may flare for a few days after the increase.

1mg (weeks 9 to 12)

Appetite reduction often becomes more noticeable. Gastrointestinal side effects may also be more noticeable around this step.

1.7mg (weeks 13 to 16)

The final escalation step before maintenance. If side effects are significant, this is a point at which prescribers sometimes consider whether to delay the next increase.

2.4mg (week 17 onwards)

The licensed maintenance dose used in the main STEP trials. In STEP 1, adults without diabetes on 2.4mg lost on average about 15% of their body weight over 68 weeks. See Wegovy results.

7.2mg (optional, for adults with obesity)

In January 2026, the MHRA approved a 7.2mg weekly dose for adults with a BMI of 30 or more, based on the STEP UP trial. According to the SmPC, the dose can be increased to 7.2mg after a minimum of four weeks on 2.4mg. In STEP UP, adults with obesity on 7.2mg lost on average about 19% of body weight over 72 weeks, compared with about 4% on placebo.

The UK leaflet initially described 7.2mg as three 2.4mg injections given on the same day. A single-injection 7.2mg pen has since been reported as available in the UK. How the dose is supplied affects the number of injections and the practicalities, so check the current SmPC and ask your prescriber or pharmacist.

The leaflet notes that some side effects, such as hair loss and altered skin sensations, are reported more often at 7.2mg. NICE had not assessed the 7.2mg dose for NHS use at the time of writing, so it is currently mainly available through private prescribers.

When the schedule changes

Delaying a dose increase

If gastrointestinal side effects are significant, the UK SmPC advises considering delaying the next dose increase or lowering to the previous dose until symptoms improve. This is a common and sensible adjustment. It is your prescriber's decision, based on how you are feeling and progressing.

Signs that it may be worth discussing a delay include:

• Persistent nausea or vomiting that stops you eating or drinking normally.
• Diarrhoea or constipation that is affecting daily life.
• Eating so little that you feel unwell or weak.

Do not delay or change your doses without discussing it with your prescriber. See Wegovy side effects and managing nausea.

Staying on a lower dose

The SmPC states 2.4mg as the maintenance dose for all indications. Some people and prescribers discuss remaining at a lower dose, for example if side effects at higher doses are hard to tolerate and weight loss is progressing. This is a clinical judgement for your prescriber, taking into account the evidence base, which is strongest for 2.4mg.

The six-month review

The SmPC states that if a person has not lost at least 5% of their initial body weight after six months on treatment, a decision is required on whether to continue. Your prescriber may consider factors such as the dose reached, side effects and other health benefits. See what if GLP-1 treatment doesn't work for you.

What the trials tell us about dose and weight loss

The 2.4mg dose was chosen for the STEP programme after earlier dose-finding studies suggested that higher doses of semaglutide produced greater weight loss than the doses used for diabetes. Across the main STEP trials, which all used 2.4mg as the target dose:

• STEP 1 (no diabetes): about 15% average weight loss over 68 weeks, versus about 2% on placebo.
• STEP 2 (type 2 diabetes): about 10% at 2.4mg, versus about 3% on placebo. This trial also included a 1mg arm, which produced less weight loss than 2.4mg, supporting a dose-response relationship.
• STEP UP (obesity): about 19% at 7.2mg over 72 weeks, versus about 4% on placebo, with a 2.4mg arm also included for comparison.

Average weight loss continued for many months after reaching the maintenance dose, typically levelling off after about a year. This is one reason prescribers usually assess progress over months rather than weeks.

Doses for people with type 2 diabetes

People with type 2 diabetes can be prescribed Wegovy for weight management if they meet the licence criteria. The dose schedule is the same. However, if you also take insulin or a sulfonylurea, such as gliclazide, your prescriber may need to reduce those medicines to lower the risk of hypoglycaemia as your blood sugar improves. You may be asked to monitor your blood sugar more closely during dose escalation. Wegovy should not be combined with other GLP-1 medicines, such as Ozempic, liraglutide or dulaglutide. See GLP-1 medication and type 2 diabetes.

Common dosing mistakes to avoid

• Increasing too quickly. Moving up before four weeks, or skipping a step, is likely to worsen side effects and is not recommended in the SmPC.
• Doubling up after a missed dose. Follow the five-day rule instead.
• Using the wrong strength pen. Pens of different strengths can look similar. Check the label each time.
• Using a pen past its in-use period. Each pen should be used within the period stated in the leaflet once in use.
• Combining with another GLP-1 medicine. Never use Wegovy alongside Ozempic, Mounjaro or another GLP-1 medicine.
• Restarting at a high dose after a long break without speaking to your prescriber.

Wegovy tablets: a different schedule

Wegovy tablets (oral semaglutide), approved by the MHRA in June 2026, follow their own daily schedule. Based on reported UK information, treatment starts at 1.5mg once daily and steps up through 4mg and 9mg to 25mg, with at least a month at each dose. The tablet must be taken whole on an empty stomach with a small sip of water, after fasting, and you should not eat or drink for at least 30 minutes afterwards. Doses of the tablet and the injection are not interchangeable. Check the current UK SmPC for the exact schedule, and see the oral semaglutide guide and switching from an injection to a tablet.

Missed doses

The UK SmPC sets out a simple rule:

Never take two doses to make up for a missed one.

Missing several doses

The SmPC does not set out a detailed restart schedule after a longer break. If you have missed two or more weeks, speak to your prescriber before your next injection. Because side effects are linked to dose changes, they may advise restarting at a lower dose and stepping up again, rather than going straight back to your previous dose. The exact approach depends on how long you have been off treatment and how you tolerated it before.

Changing your injection day

According to the SmPC, you can change the day of your weekly injection if needed, as long as there are at least three days (more than 72 hours) between doses. After changing, continue on the new day each week.

Examples:

• If you usually inject on Monday morning and want to move to Thursday, you could take your next dose on Thursday later in the day, so that more than 72 hours have passed, and then continue on Thursdays.
• If you usually inject on Monday and want to move to Wednesday, injecting on the Wednesday straight after your Monday dose would leave only two days between doses, which does not meet the rule. Instead, you could take your next dose on the Wednesday of the following week, or move gradually.

If in doubt, ask your pharmacist to help you plan the change.

Our guide to storing and travelling with Mounjaro covers practical travel tips that apply equally to Wegovy pens.

Injection basics at every dose

Whatever your dose, the basics of injecting are the same:

• Inject once a week, on the same day, at any time of day, with or without food.
• Inject under the skin of the abdomen, thigh or upper arm, as shown in the instructions for use.
• Rotate sites each week to reduce skin reactions.
• Use a new needle for every injection and dispose of it in a sharps bin.
• Check the solution is clear and colourless before use.
• Store pens as the leaflet describes: in the fridge before first use, and within the in-use period and temperature limits once started.

If you are new to injecting, ask your pharmacist or prescriber to talk you through the first injection, or watch the manufacturer's official training materials. Our FlexTouch pen guide covers each step.

Wegovy doses compared with Ozempic and Mounjaro

Milligram doses cannot be compared between different medicines: 2.4mg of semaglutide is not "less" than 15mg of tirzepatide in any meaningful sense, because the molecules differ in potency. See Mounjaro doses explained, Ozempic vs Wegovy and the oral semaglutide guide.

Switching to or from Wegovy

There is no official conversion table between Wegovy and Mounjaro. When switching, prescribers usually consider the dose you were on, how well you tolerated it, and how long since your last dose. Many start the new medicine at or near its starting dose and titrate up. See switching from Wegovy to Mounjaro and switching from Mounjaro to Wegovy.

Adolescents

Wegovy is licensed for weight management in adolescents aged 12 and over with obesity. The dose schedule follows the same escalation to 2.4mg, under specialist supervision. The 7.2mg dose is licensed for adults only.

Dose and cost

Some private providers price Wegovy differently by dose, and the 7.2mg dose may involve different supply arrangements. Other factors affecting cost include consultation fees, follow-up and delivery. We do not quote prices because they change frequently; see Wegovy prices explained and our prices page.

If you are comparing regulated services, consider how each handles dose reviews and side effect support, not just cost. Our provider comparison sets out the differences.

Practical tips for staying on schedule

• Choose a consistent day that fits your routine, and set a phone reminder.
• Keep a simple log of the date, dose and injection site.
• Order your next pen in good time, especially before a dose increase, so that you have the right strength ready.
• Check the strength on each new pen before injecting.
• Rotate injection sites between the abdomen, thighs and upper arms.
• Plan around travel and events, using the rule on changing your injection day if needed.

Long-term dosing

There is no fixed end date in the licence. The STEP 4 trial and the STEP 1 extension showed that most people regain weight after stopping. NHS treatment under NICE TA875 is limited to two years in specialist services. Whether to continue long term, reduce the dose or stop is a decision for you and your prescriber. See Wegovy maintenance and stopping.

When to speak to a professional

Speak to your prescriber or pharmacist if:

• You are unsure which dose you should be taking or when to increase.
• Side effects are making it hard to step up.
• You have missed more than one dose.
• You are considering changing your injection day and are unsure how.
• You want to discuss the 7.2mg dose, staying at a lower dose, or stopping.
• You are planning pregnancy; the SmPC advises stopping semaglutide at least two months beforehand.

Seek urgent medical help (NHS 111, or 999 / A&E in an emergency) if you have:

• Severe, persistent abdominal pain, which may spread to your back, with or without vomiting.
• Persistent vomiting or diarrhoea with signs of dehydration, such as confusion or passing very little urine.
• Signs of a serious allergic reaction, such as swelling of the face, lips or throat, or difficulty breathing.

If you think you have injected more than your prescribed dose, contact your prescriber, pharmacist or NHS 111 for advice, as side effects such as nausea and vomiting may be more severe.

All dosing decisions, including increases, delays and stopping, belong to your prescriber.